[1]张乐国a,朱翠敏b,夏瑞雪a,等.急性脑梗死患者静脉溶栓前后血清sCD163，ANGPTL3水平变化与临床预后的相关性研究[J].现代检验医学杂志,2025,40(01):148-152.[doi:10.3969/j.issn.1671-7414.2025.01.028]
　ZHANG Leguoa,ZHU Cuiminb,XIA Ruixuea,et al.Correlation between Serum sCD163，ANGPTL3 Levels and Clinical Prognosis in Patients with Acute Cerebral Infarction before and after Intravenous Thrombolysis[J].Journal of Modern Laboratory Medicine,2025,40(01):148-152.[doi:10.3969/j.issn.1671-7414.2025.01.028]
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急性脑梗死患者静脉溶栓前后血清sCD163，ANGPTL3水平变化与临床预后的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年01期
页码:
148-152
栏目:
论著
出版日期:
2025-01-15

文章信息/Info

Title:
Correlation between Serum sCD163，ANGPTL3 Levels and Clinical Prognosis in Patients with Acute Cerebral Infarction before and after Intravenous Thrombolysis
文章编号:
1671-7414（2025）01-148-05
作者:
张乐国a; 朱翠敏b; 夏瑞雪a; 贾建普a; 张丽冉a; 赵泽宇a; 霍虹达c; 齐曼曼d
（沧州市中心医院 a. 神经内科；b. 宣传策划科；c. 门护部；d. 麻醉科，河北沧州 061001）
Author(s):
ZHANG Leguoa; ZHU Cuiminb; XIA Ruixuea; JIA Jianpua; ZHANG Lirana; ZHAO Zeyua; HUO Hongdac;  QI Manmand
（a. Department of Neurology; b. Department of Propaganda and Planning; c. Department of Door Care; d. Department of Anesthesia, Cangzhou Central Hospital, Hebei Cangzhou 061001, China）
关键词:
急性脑梗死; 静脉溶栓; 可溶性清道夫受体163; 血管生成素样蛋白3
分类号:
R743.33；R392.11
DOI:
10.3969/j.issn.1671-7414.2025.01.028
文献标志码:
A
摘要:
目的 探讨急性脑梗死（acute cerebral infarction，ACI）患者静脉溶栓前后血清可溶性清道夫受体163（solublescavenger receptor 163，sCD163）、血管生成素样蛋白3（angiopoietin-like protein，ANGPTL3）水平变化及与预后的相关性。方法 选取沧州市中心医院2021 年6 月～ 2022 年6 月收治的60 例ACI 患者为ACI 组，另选取同期60 例健康体检者为对照组。60 例患者入院后根据美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）得分分为轻度组（n=10）、中度组（n=38）和重度组（n=12），根据患者溶栓后90 天改良Rankin 量表分数分为预后良好组（n=42）和预后不良组（n=18）。血清sCD163 和ANGPTL3 水平采用酶联免疫吸附试验（ELISA）检测；受试者工作特征（ROC）曲线分析血清sCD163 和ANGPTL3 水平对ACI 患者静脉溶栓治疗后预后的预测价值。结果 与对照组比较，ACI 组血清sCD163（687.55±86.43 ng/ml vs 411.07±58.24 ng/ml），ANGPTL3（60.28±10.55 mg/L vs 25.34±5.93 mg/L）水平均明显升高，差异具有统计学意义（t=20.549，22.363，均P ＜ 0.05）。轻度组、中度组和重度组血清sCD163（551.65±69.66 ng/ml， 668.92±81.12 ng/ml，859.79±117.24 ng/ml），ANGPTL3（44.52±8.12 mg/L，58.67±10.37mg/L，75.34±13.12 mg/L）水平逐渐升高，差异具有统计学意义（F=36.011，23.007，均P ＜ 0.05）。与预后良好组比较，预后不良组发病至溶栓时间≥ 3h 的占比、入院时NIHSS 评分＞ 10 分占比、溶栓前后血清sCD163 和ANGPTL3水平均明显升高，差异具有统计学意义（t/χ2=5.644，4.775，8.982，10.866，10.293，9.702，均P ＜ 0.05）。ROC 结果显示，血清sCD163，ANGPTL3 水平单独预测ACI 患者预后的曲线下面积（95% 置信区间）[AUC（95％ CI）] 为0.830（0.711 ～ 0.915）和0.783（0.658 ～ 0.879），敏感度和特异度分别为72.22% 和85.71%，77.78% 和85.71%；血清sCD163 和ANGPTL3 联合预测ACI 患者预后的AUC（95％ CI）[0.950（0.861 ～ 0.990）] 显著大于sCD163 和ANGPTL3 单独预测（Z=2.378，2.109，P=0.017，0.035）。结论 sCD163 和ANGPTL3 在ACI 患者血清中水平升高，且与患者严重程度和预后有关。
Abstract:
Objective To investigate the changes of serum levels of soluble scavenger receptor 163 (sCD163)，angiopoietinlike protein 3 (ANGPTL3) before and after intravenous thrombolysis in patients with acute cerebral infarction (ACI) and their correlation with prognosis. Methods A total of 60 ACI patients accepted by Cangzhou Central Hospital from June 2021 to June 2022 were collected as the ACI group, and another 60 healthy individuals were regarded as the control group. According to the National Institutes of Health Stroke Scale (NIHSS) score after admission, 60 patients were divided into mild group (n=10), moderate group (n=38) and severe group (n=12).According to the scores on the modified Rankin scale 90 days after thrombolysis, patients were separated into a good prognosis group (n=42) and a poor prognosis group (n=18). The serum levels of sCD163 and ANGPTL3 were detected using enzyme linked immunosorbent assay (ELISA), and receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum sCD163 and ANGPTL3 levels for the prognosis of ACI patients after intravenous thrombolysis therapy. Results Compared with the control group, the levels of serum sCD163 (687.55 ± 86.43 ng/ml vs 411.07 ± 58.24 ng/ml) and ANGPTL3 (60.28 ± 10.55 mg/L vs 25.34 ± 5.93 mg/L) in ACI group were significantly increased，and the differences were significant (t=20.549, 22.363, all P < 0.05). The levels of serum sCD163 (551.65 ± 69.66 ng/ml, 668.92 ± 81.12 ng/ml，859.79 ± 117.24 ng/ml) and ANGPTL3 (44.52 ± 8.12 mg/L, 58.67 ± 10.37 mg/L, 75.34 ± 13.12 mg/L) in mild, moderate and severe groups were gradually increased, and the differences were significant (F=36.011, 23.007, all P<0.05). Compared with the good prognosis group, the proportion of time from onset to thrombolysis ≥ 3 h, the proportion of NIHSS score > 10 at admission, and the serum sCD163 and ANGPTL3 levels before and after thrombolysis were significantly increased in the poor prognosis group, and the differences were statistically significant (t/x2=5.644, 4.775, 8.982, 10.866, 10.293, 9.702, all P ＜ 0.05). ROC results showed that the area under the curves（95% confidence intervals）[AUC（95%CI）] of serum sCD163 and ANGPTL3 level alone in predicting the prognosis of ACI patients were 0.830 (0.711 ～ 0.915) and 0.783 (0.658~0.879), and their sensitivity and specificity were 72.22% and 85.71%, 77.78% and 85.71%, respectively. The AUC（95%CI）of combined prediction of serum sCD163 and ANGPTL3 in predicting the prognosis of ACI patients [0.950（0.861 ～ 0.990）] was obviously greater than the AUC predicted by sCD163 and ANGPTL3 alone (Z=2.378, 2.109，P=0.017，0.035). Conclusion sCD163 and ANGPTL3 levels are elevated in the serum of ACI patients, and are related to their severity and prognosis.

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备注/Memo

备注/Memo:
基金项目：河北省2022 年度医学科学研究课题计划（20220371）。
作者简介： 张乐国（1982-）, 男，硕士研究生，副主任医师，研究方向：脑血管病及神经感染与免疫研究，E-mail：zi148sp@163.com。
更新日期/Last Update: 2025-01-15